经会阴超声评估全子宫切除术对后盆腔功能的影响

目的 运用经会阴超声评估全子宫切除术对女性后盆腔功能的影响.方法 选取盆腔良性病变女性患者90例,术前、术后3、6、12个月均应用经会阴超声对后盆腔器官位置、结构进行观察,记录静息和最大Valsalva动作下肛直肠角度,会阴体运动过度、直肠膨出发生例数,评估全子宫切除术对后盆腔器官结构和功能的影响.结果 术前静息和最大Valsalva动作下肛直肠角度分别为(115.67±13.07)°和(110.21±12.50)°,会阴体运动过度、直肠膨出发生例数分别为5例、3例;术后3个月静息和最大Valsalva动作下肛直肠角度分别为(121.15±15.05)°和(115.26±11.24)°,会阴体运动过度、直肠膨出发生例数分别为13例、5例;术后6个月静息和最大Valsalva动作下肛直肠角度分别为(125.15±14.05)°和(118.36± 10.20)°,会阴体运动过度、直肠膨出发生例数分别为15例、10例;术后12个月静息和最大Valsalva动作下肛直肠角度分别为(128.91±14.06)°和(120.26± 11.34)°,会阴体运动过度、直肠膨出发生例数分别为21例、15例;与术前比较,术后3个月静息和最大Valsalva动作下肛直肠角度、会阴体运动过度、直肠膨出比较差异无统计学意义;术后6、1 2个月静息和最大Valsalva动作下肛直肠角度较术前增大,差异有统计学意义(P＜0.05);术后6、12个月会阴体运动过度、直肠膨出发生率高于术前,差异有统计学意义(P＜0.05).结论 全子宫切除术可以导致女性后盆腔器官结构及功能不同程度改变.经会阴超声可以较好的评估后盆腔结构与功能.

Evaluation the influence of total hysterectomy on the posterior pelvic function by transperineal ultrasonography

Objective To evaluate the influence of total hysterectomy on the posterior pelvic function by transperineal ultrasonography.Methods 90 female patients with pelvic benign lesions were selected.Observed the position and structure of the posterior pelvic organs by transperineal ultrasonography before and 3,6,12 months after total hysterectomy,recorded the anorectal angles on resting state and the maximum Valsalva maneuver,the number of cases of perineal body hyperkinesia and rectal prolapse,then evaluated the effect of total hysterectomy on the structure and function of the posterior pelvic organs.Results Preoperative anorectal angles on resting state and the maximum Valsalva maneuver were (1 15.67±13.07)° and (110.21±12.50)°,the number of cases of perineal body hyperkinesia and rectal prolapse were 5 and 3,those 3 months after surgery were (121.15±15.05)° and (115.26±11.24)°,13 and 5,those 6 months after surgery were (125.15±14.05)° and (118.36±10.20)°,15 and 10,those 12 months after surgery were (128.91±14.06)° and (120.26±11.34)°,21 and 15;compared with those before surgery,the anorectal angles on resting state and the maximum Valsalva maneuver,the rates of perineal body hyperkinesia and rectal prolapse 3 months after surgery did not change significantly,the anorectal angles on resting state and the maximum Valsalva maneuver 6,12 months after surgery significantly increased (P＜0.05),the rates of perineal body hyperkinesia and rectal prolapse 6,12 months after surgery were higher (P＜0.05).Conclusion Total hysterectomy can induce different degrees of structure and functional injuries of female posterior pelvic organs.Transperineal ultrasound can well evaluate the posterior pelvic function.